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Editorial: State recklessly played down tuberculosis outbreak

Editorial: State recklessly played down tuberculosis outbreak

Despite protestations by state officials, the Florida Department of Health failed in its mission when the agency kept secret from the general public a tuberculosis outbreak in Duval County. How can the department protect public health if the public doesn’t know that it’s at risk?

“We immediately reached out to the Centers for Disease Control and Prevention and engaged stakeholders in the community,” came the bureaucratese from Deputy Secretary for Health Steven Harris. “Contacting these local government officials, community organizations and hospitals is a clear sign that these actions were conducted with the utmost level of transparency.”

If that were true, it wouldn’t have taken Sunday’s story by The Post’s Stacey Singer for the rest of the state to learn that Duval County has had 99 cases of TB since 2004, the vast majority since 2008, when a schizophrenic patient in Jacksonville contracted the disease and infected 17 others after going undiagnosed for eight months. The strain also has been linked to 13 deaths. The state called in the CDC in February, when the cases spiked from 10 in 2010 to 30 in 2011.

Stunningly, Dr. Harris claimed that because the disease is isolated to the homeless population in Jacksonville, it doesn’t pose a threat to the general population. “We only identify an investigation when there’s a need to get help, perhaps from the media, to identify people who may have come in contact with the contagious organism,” he told News Service Florida. “In this particular case in the Duval County area, we had the disease essentially under control in terms of knowing what communities were being affected, where it was being affected.”

Only in Dr. Harris’ delusional world are homeless people so isolated that any contagious disease they carry would pose a threat only to other homeless individuals. In the real world, homeless people panhandle in public places, use public restrooms and take public transportation. They also use emergency rooms. So if they have a contagious disease, such as tuberculosis, they threaten everyone.

Also, how could Dr. Harris characterize what the CDC has called the worst outbreak of TB the agency has assisted with in 20 years as “essentially under control”? The CDC estimates that at least 3,000 individuals have come into close contact with contagious people but have yet to be evaluated. Officials don’t know how to find them. This is exactly the kind of situation in which to notify the media, which would notify the public.

In its 25-page report, the CDC says the outbreak is still not contained. In fact, the agency cites the “large number of contacts who have not yet been evaluated” as a major factor contributing to the “size and complexity of the outbreak.” Robert Luo, author of the CDC report, wrote that if the number of cases per month in 2012 remains the same for the rest of the year “the total number of 2012 cases will rival the high number of 2011 cases, suggesting that this outbreak has yet to show signs of abating.”

If that’s true, what’s to keep the outbreak isolated to Duval? Homeless individuals are among the most transient in the population. Those 3,000 people who still need to be evaluated could be anywhere.

We think that the state purposefully kept the outbreak a secret while legislators rushed to close A.G. Holley Hospital in Lantana. The state’s only TB sanatorium is no longer treating patients, even though it wasn’t scheduled to close until Jan. 1. The Department of Health had no real plan for closing the facility, so several patients have been released into the community, where they supposedly will be treated and monitored by local health departments.

Patients were sent to A.G. Holley, though, only because they failed treatment in the community. The facility handled the hardest cases. Only a few of the Duval County cases so far fit that description. But there could be more.

First, Gov. Scott should appoint a task force to investigate the handling of the TB outbreak. Legislators then must realize that they made a mistake in closing A.G. Holley, and need a real plan for handling the state’s hardest-to-treat tuberculosis cases.